I laughed my socks off and it wasn’t funny!

By Terry - Our PhysioJuly 16, 2018

(Warning! bad puns ahead!)

You know bladder leakage trouble when there’s a queue for the loo and the double expresso you had instead of breakfast has woken your bladder from its peaceful slumber and it’s now behaving like a 2 year old having a devastating temper tantrum.

Why was there no warning? And why does my pee make my legs twist up like that and why is it sooo hard to hold on?

If this sounds like a familiar story, you might have urinary urgency, which can cause an irresistible need to empty your bladder with no warning. Luckily you’ve been doing your pelvic floor muscle training and there is a loo behind that door otherwise those beautiful new socks might have to go into the bin like mine did. If you do wet your socks it’s called urge incontinence and suddenly there’s a whole new meaning to “laughing your socks off”

Urinary urgency often goes hand in hand with a need to visit the toilet more than anyone else. If you drink between 1.5L and 2L, you could expect to pee 4 to 6 times a day and not at all most nights. Each pee would be between 250ml and 500ml and your bladder would feel completely empty afterwards.

For some people the problem lies in the bladder which is overactive or it might be years of habit or even be caused by constipation.

That double expresso and any other caffeine is a common trigger for urgency, but other triggers may be spicy foods, fizzy drinks, cold weather, laughing, hearing or seeing running water, walking past the loo, taking your keys out of your pocket etc. Your friends and family who do not suffer from urgency may think you’re crazy to walk the long way around to avoid that pesky fountain in the quad, but the crew at Go Against the flow know exactly how you feel.

For most people the problem can get heaps better by following a few simple rules.

Keep yourself well hydrated. Concentrated urine irritates the bladder, so avoiding fluid can make the problem worse. 1.5L to 2L of fluid is a good amount for most people. Check your urine concentration using this handy colour chart

Empty your bladder when it feels full and not “just in case”. Emptying your bladder before and after each class just trains it to hold less urine. Your bladder might also learn to empty in response to unrelated cues such as taking your keys out of your bag, or filling your water bottle. Exceptions to rule 2 apply when you’re getting ready to go to sleep, after sex or before that 4-hour bus trip with no toilet breaks.

Eat plenty of healthy fruit and vegies to avoid constipation. Constipation is a common cause of bladder urgency.

Write down how much you drink and pee for a few days. Knowing whether your bladder is misbehaving because it’s genuinely busting or whether it’s only half full is really important.

If you’re peeing often and emptying 500ml or more each time, you might just be drinking too much. If you find it difficult to drink less, your doctor can do some test to see why you are always thirsty.

If you’re rushing to the toilet and peeing less than 250ml each time, you can try some strategies to slow your bladder down called urge suppression techniques.

Ask a pelvic health physiotherapist or continence nurse to help you train your bladder to hold more urine.

If all else fails, your doctor may prescribe medication that can calm your bladder down.